#Metoo in Medicine

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by Anonymous, MD (for fear of retaliation)

I recently conducted an informal survey among fellow physician moms on Facebook’s Physician Moms Group page. I asked my female physicians friends to talk about their experiences with sexism, sexual harassment and sexual assault in medical school, residency and post-residency. Medicine in the United States has historically been a field dominated by white males. It’s only been in the last 40 years that women have been permitted to don the title of “Doctor” on a consistent basis. Finally, in 2017, U.S. medical schools are admitting a near equal proportion of male and female medical students. Unfortunately, the equal treatment in the field stops there. Female medical students are disproportionately encouraged to go into “softer” fields of medicine – internal medicine, psychiatry, pediatrics – and leave surgical specialties to the men. Indeed, in our present day, women make up only 10-30% of surgical residents in this country. The women that do enter these male-dominated subspecialties are often subject to persistent yet subtle discrimination by their male counterparts in what often feels like a concerted effort (be it conscious or subconscious) to push them out of the field along the course of their training and careers (see excellent book by Dr. Frances Conley, “Walking Out on the Boys”). As medicine is also an inherently hierarchical profession, it proves very easy for male colleagues to “get away” with daily sexist comments, harassment, and in some cases sexual assault. Complain, and lose your promotion. Raise your voice, and be fired. The boys will be sure to have each others’ backs. Fears of retaliation, including the incineration of hard-earned careers, paralyze the female practitioner from taking action.

Of the numerous stories shared in my survey, only two doctors ever reported their stories of sexual harassment and assault to authorities. In one case, the young doctor’s residency program director fully supported her through the traumatic process and vowed that sexual discrimination, harassment and assault would not be tolerated in his program.

The other doctor was not so lucky. Her case ultimately ended in litigation, and she had to fight tooth-and-nail to preserve her career and reputation in an environment in which her program director and other physician colleagues were tearing her to pieces – trying to force her out of medicine altogether.

Not surprisingly, in this traditionally white male field where all power seems to reside in the hands of very few at the top, only one physician of those surveyed had a suggestion as to what to do about the persistent problem of sexual discrimination, harassment and assault among female medical students, residents and physicians: “Work on holding the Accreditation Council for Graduate Medical Education (ACGME) accountable,” and “We need to identify a few leaders amongst female residency program directors to put forth resolutions in the Program Director Associations.”

Of the 145 neurosurgery residency program directors, only one is a woman.

Learning Optimism

In the classic positive psychology text,Β Learned Optimism, Martin Seligman, PhD discusses the importance of optimism in surviving and thriving through setbacks and failures. It is optimism that distinguishes the most successful from the rest.

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Anatomically, optimism in the brain has been localized to the rostral anterior cingulate cortex and amygdala –Β two areas that can be strengthened with practice. As a minority in one’s chosen field, the stronger you can make these areas of your brain, the more you can persist through difficulties and discrimination with equanimity and ease.

“Nothing in this world can take the place of persistence. Talent will not: nothing is more common than unsuccessful men with talent. Genius will not; unrewarded genius is almost a proverb. Education will not: the world is full of educated derelicts. Persistence and determination alone are omnipotent.” -Calvin Coolidge